Healthcare Provider Details

I. General information

NPI: 1548623283
Provider Name (Legal Business Name): ELIZABETH ARLENE SLAVINSKAS RN, FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ELIZABETH ARLENE ANDRYSIAK RN, FNP-BC

II. Dates (important events)

Enumeration Date: 03/31/2016
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

211 N EDDY ST
SOUTH BEND IN
46617-2808
US

IV. Provider business mailing address

22818 OLD US 20
ELKHART IN
46516-9150
US

V. Phone/Fax

Practice location:
  • Phone: 574-237-9231
  • Fax:
Mailing address:
  • Phone: 574-389-1231
  • Fax: 574-389-1232

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WE0003X
TaxonomyEmergency Registered Nurse
License Number28193462A
License Number StateIN
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number71006187A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: